Loading...
5 results
Search Results
Now showing 1 - 5 of 5
- Nutritional risks and colorectal cancer in a Portuguese populationPublication . Ravasco, Paula; Monteiro Grillo, isabel; Marques-Vidal, Pedro; Camilo, MariaBackground: Food and nutrition as major causes of colorectal cancer (CRC) are still debatable. Aim of the study: This cross-sectional study in a Portuguese population aimed to characterize and identify "high-risk" diets/life-styles and explore their associations with colorectal cancer. Methods: In 70 colorectal cancer patients and 70 sex, age-matched subjects without cancer history, we evaluated: diet history and detailed nutrient intake (DIET-PLAN5 2002, UK), alcohol (amount, type, years), smoking (number packages/year, years), physical activity, co-morbidities and body mass index. Age-adjusted Relative Risks were calculated, Proportional Hazards models adjusted the analysis for multiple risk factors. Results: Smoking was a risk factor (1.90). Increased colorectal cancer risk regarding the lowest vs the highest intake quartile emerged for: vitamin B12 (3.41), cholesterol (3.15), total fat (2.87), saturated fat (1.98), animal protein (1.95), energy (1.85), alcohol (1.70), iron (1.49), refined carbohydrates (1.39). Reduced colorectal cancer risk for the highest vs the lowest intake quartile was found for: n-3 fatty acids (0.10), insoluble fiber/folate (0.15), flavonoids/vitamin E (0.25), isoflavones/beta-carotene (0.30), selenium (0.36), copper (0.41), vitamin B6 (0.46). Conclusion: Our results corroborated well-established risk factors and identified emergent nutrients. Prolonged excessive intake of macronutrients and some micronutrients concurrent with marked deficits of fiber and protective compounds were dominant in colorectal cancer and more significant than alcohol and smoking. The interaction diet-colorectal cancer is consistent and the relevance of new nutrients is emerging.
- Cancer wasting and quality of life react to early individualized nutritional counselling!Publication . Ravasco, Paula; Monteiro Grillo, Isabel; Camilo, MariaTo devise a meaningful nutritional therapy in cancer, a greater understanding of nutritional dimensions as well as patients' expectations and disease impact is essential. We have shown that nutritional deterioration in patients with gastrointestinal and head and neck cancer was multifactorial and mainly determined by the tumour burden and location. In a larger cohort, stage and location were yet again the major determinants of patients' quality of life (QoL), despite the fact that nutritional deterioration combined with intake deficits were functionally more relevant than cancer stage. Based on this framework, the potential role of integrated oral nutritional support on outcomes was investigated. In a pilot study using individualized nutritional counselling on a heterogeneous patient population, the achieved improvement of nutritional intake was proportional to a better QoL. The role of early nutritional support was further analysed in a prospective randomized controlled trial in head and neck cancer patients stratified by stage undergoing radiotherapy. Pre-defined outcomes were: nutritional status and intake, morbidity and QoL, at the end and 3 months after radiotherapy. Nutritional interventions, only given during radiotherapy, consisted of three randomization arms: (1) individualized nutritional counselling vs. (2) ad libitum diet+high protein supplements vs. (3) ad libitum diet. Nutritional interventions 1 and 2 positively influenced outcomes during radiotherapy; however, 3 months after its completion individualized nutritional counselling was the single method capable of sustaining a significant impact on patients' outcomes. The early provision of the appropriate mixture of foods and textures using regular foods may modulate outcomes in cancer patients.
- Cancer : disease and nutrition are key determinants of patients' quality of lifePublication . Monteiro Grillo, Isabel; Marques-Vidal, Pedro; Camilo, Maria; Ravasco, PaulaGoals of work: The aims of this study were (1) to evaluate quality of life (QoL), nutritional status and dietary intake taking into account the stage of disease and therapeutic interventions, (2) to determine potential interrelationships, and (3) to quantify the relative contributions of the cancer, nutrition and treatments on QoL. Patients and methods: In this prospective cross-sectional study conducted in 271 head and neck, oesophagus, stomach and colorectal cancer patients, the following aspects were evaluated: QoL (EORTC-QLQ C30), nutritional status (percent weight loss over the previous 6 months), usual diet (comprehensive diet history), current diet (24-h recall) and a range of clinical variables. Main results: Usual and current intakes differed according to the site of the tumour ( P=0.02). Patients with stage III/IV disease showed a significant reduction from their usual energy/protein intake ( P=0.001), while their current intakes were lower than in patients with stage I/II disease ( P=0.0002). Weight loss was greater in patients with stage III/IV disease than in those with stage I/II disease ( P=0.001). Estimates of effect size revealed that QoL function scores were determined in 30% by cancer location, in 20% by nutritional intake, in 30% by weight loss, in 10% by chemotherapy, in 6% by surgery, in 3% by disease duration and in 1% by stage of disease. Likewise in the case of symptom scales, 41% were attributed to cancer location, 22% to stage, 7% to nutritional intake, 7% to disease duration, 4% to surgery, 1% to weight loss and 0.01% to chemotherapy. Finally for single items, 30% were determined by stage, 20% by cancer location, 9% by intake, 4% by surgery, 3% by weight loss, 3% by disease duration and 1% by chemotherapy. Conclusions: Although cancer stage was the major determinant of patients' QoL globally, there were some diagnoses for which the impact of nutritional deterioration combined with deficiencies in nutritional intake may be more important than the stage of the disease process.
- Qual o perfil nutricional e de estilos de vida do doente oncológico? Estudo transversalPublication . Rolão, Andreia; Monteiro Grillo, Isabel; Camilo, Maria; Ravasco, PaulaBackground: Cancer aetiology is multifactorial and risk factors include: obesity, central adiposity, sedentarism, excessive or deficient intake of foods and/or nutrients with pro-carcinogenic effects vs protective ones. Objectives: To evaluate the pattern of nutritional status, life styles, physical activity and diet in a cohort of cancer patients. Methods: This pilot cross-sectional study was conducted in 64 patients referred for radiotherapy at the Radiotherapy Department of the University Hospital of Santa Maria (CHLN). Evaluations were: waist circumference associated with potential cardio-metabolic risk, body composition by Tetrapolar Bioimpedance Analysis (XITRON®), Body Mass Index, dietary intake pattern with a short food frequency questionnaire, physical activity with Jackson questionnaire. Results: The most frequent diagnosis were breast and colorectal cancers; 53% of patients were overweight/obese, and there was a significant correlation between this nutritional pattern and weight gain in comparison with usual weight (p<0.005). There were 78% of patients with a waist circumference above the maximum cut-off limit, indicating moderate/ high cardio-metabolic risk, and most were female patients (87%). The great majority of patients (61%) had excessive fat mass highly above the maximum recommended cut-off value, especially male patients (74%). The dietary pattern was poor in vegetables (55%) and excessive in meat and simple carbohydrates (78%); physical activity was low with a high prevalence of sedentarism. Conclusions: This population presented excessive body weight, excessive fat mass, high cardio-metabolic risk, sedentarism and an unbalanced diet poor in protective foods/nutrients. This population's life styles and nutritional pattern, may be considered of risk in oncology disease. The elevated and growing incidence of cancer in Portugal, reinforces the need for further research in order to identify nutritional factors involved in the etiology/evolution and probably prognosis of cancer.
- Does nutrition influence quality of life in cancer patients undergoing radiotherapy?Publication . Ravasco, Paula; Monteiro Grillo, Isabel; Camilo, MariaPurpose: To investigate in cancer patients referred for radiotherapy (RT): (1) quality of life (QoL), nutritional status and nutrient intake, at the onset and at the end of RT; (2) whether individualised nutritional counselling, despite symptoms, was able to enhance nutrient intake over time and whether the latter influenced the patient's QoL; and (3) which symptoms may anticipate poorer QoL and/or reduced nutritional intake. Material and methods: One hundred and twenty-five patients with tumours of the head-neck/gastrointestinal tract (high-risk: HR), prostate, breast, lung, brain, gallbladder, uterus (low-risk: LR) were evaluated before and at the end of RT. Nutritional status was evaluated by Ottery's Subjective Global Assessment, nutritional intake by a 24-h recall food questionnaire and QoL by two instruments: EUROQOL and the European Organisation for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30. Results: Baseline malnutrition was prevalent in HR vs. LR (P=0.02); nutritional intake was associated with nutritional status (P=0.007); the latter did not change significantly during RT. In LR, baseline energy intake was higher than EER (P=0.001), and higher than HR' intake (P=0.002); the latter increased (P<0.03), in spite of symptom increase anew and/or in severity (P=0.0001). According to both instruments, QoL was always better in LR vs. HR (P=0.01); at the end of RT, QoL improvement in HR was correlated with increased nutritional intake (P=0.001), both remained stable in LR. Conclusions: Individualised nutritional counselling accounting for nutritional status and clinical condition, was able to improve nutritional intake and patients' QoL, despite self-reported symptoms.